TY - JOUR T1 - Analysis of static pelvic tilt variations in transfemoral prosthesis users: comparison of different socket designs with healthy controls TT - Statik pelvik tilt varyasyonlarının transfemoral protez kullanıcılarında analizi: farklı soket tasarımlarının sağlıklı kontrollerle karşılaştırılması AU - Yılmaz, Kamil PY - 2025 DA - March Y2 - 2025 DO - 10.32322/jhsm.1607601 JF - Journal of Health Sciences and Medicine JO - J Health Sci Med /JHSM /jhsm PB - MediHealth Academy Yayıncılık WT - DergiPark SN - 2636-8579 SP - 210 EP - 214 VL - 8 IS - 2 LA - en AB - Aims: The aim of this study was to investigate pelvic tilt angles in patients with transfemoral prosthesis, considering different socket designs, and to compare them with healthy controls.Methods: In this cross-sectional study, 28 male participants were enrolled, including 14 unilateral transfemoral prosthesis users (prosthesis group) and 14 demographically similar healthy subjects (control group). Pelvic tilt angles in both sagittal and frontal planes were measured using a digital inclinometer mounted on a two-arm caliper.Results: All participants had anterior pelvic tilt. Within the prosthesis group, there was no significant difference in anterior pelvic tilt and lateral pelvic tilt angles between the prosthetic side and the contralateral side (p=0.106, effect size (ES)=0.464; p=0.055, ES=-0.564, respectively). There was no significant difference in anterior pelvic tilt and lateral pelvic tilt angles between the prosthetic side and the contralateral side of the participants using both quadrilateral socket design and ischial containment socket designs (p=0.499, ES=-0.256; p=0.128, ES=-0.575; p=0.063, ES=-0.703; p=0.612, ES=-0.192, respectively). However, a significant difference was found in both the right and left anterior pelvic tilt angles and the lateral pelvic tilt angles between the prosthesis group and the control group (p=0.001, ES=-0.582; p KW - Transfemoral prostheses KW - pelvic tilt angle KW - anterior pelvic tilt KW - lateral pelvic tilt N2 - Amaçlar: Bu çalışmanın amacı, transfemoral protez kullanan hastalarda pelvik tilt açılarını farklı soket tasarımlarına göre incelemek ve sağlıklı bireylerle karşılaştırmaktı.Yöntemler: Bu kesitsel çalışmaya, 14 tek taraflı transfemoral protez kullanıcısı (protez grubu) ve 14 demografik olarak benzer sağlıklı birey (kontrol grubu) olmak üzere 28 erkek katılımcı dahil edildi. Sagittal ve frontal düzlemlerdeki pelvik tilt açıları, iki kollu bir kumpas üzerine monte edilen dijital inklinometre ile ölçüldü.Bulgular: Tüm katılımcılarda anterior pelvik tilt vardı. Protez grubunda, protezli taraf ile kontralateral taraf arasında anterior pelvik tilt ve lateral pelvik tilt açılarında anlamlı bir fark yoktu (sırasıyla p=0.106, Etki Büyüklüğü (EB)=0.464; p=0.055, EB=-0.564). Hem quadrilateral soket tasarımı hem de ischial containment soket tasarımı kullanan katılımcıların protezli tarafları ile kontralateral tarafları arasında anterior pelvik tilt ve lateral pelvik tilt açılarında anlamlı bir fark yoktu (sırasıyla p=0.499, EB=-0.256; p=0.128, EB=-0.575; p=0.063, EB=-0.703; p=0.612, EB=-0.192). Bununla birlikte, protez grubu ile kontrol grubu arasında hem sağ ve sol anterior pelvik tilt açılarında hem de lateral pelvik tilt açılarında anlamlı bir fark bulundu (sırasıyla p=0.001, EB=-0.582; p CR - Preece SJ, Willan P, Nester CJ, Graham-Smith P, Herrington L, Bowker P. Variation in pelvic morphology may prevent the identification of anterior pelvic tilt. J Man Manip Ther. 2008;16(2):113-117. doi:10.1179/ 106698108790818459 CR - Suits WH. Clinical measures of pelvic tilt in physical therapy. Int J Sports Phys Ther. 2021;16(5):1366-1375. doi:10.26603/001c.27978 CR - Herrington L. Assessment of the degree of pelvic tilt within a normal asymptomatic population. Man Ther. 2011;16(6):646-648. doi:10.1016/j.math.2011.04.006 CR - Crossley KM, Schache AG, Ozturk H, Lentzos J, Munanto M, Pandy MG. Pelvic and hip kinematics during walking in people with patellofemoral joint osteoarthritis compared to healthy age-matched controls. Arthritis Care Res (Hoboken). 2018;70(2):309-314. doi:10.1002/acr.23261 CR - Król A, Polak M, Szczygieł E, Wójcik P, Gleb K. Relationship between mechanical factors and pelvic tilt in adults with and without low back pain. J Back Musculoskelet Rehabil. 2017;30(4):699-705. doi:10.3233/BMR-140177 CR - Kuwahara W, Kurumadani H, Tanaka N, et al. Correlation between spinal and pelvic movements during gait and aggravation of low back pain by gait loading in lumbar spinal stenosis patients. J Orthop Sci. 2019;24(2):207-213. doi:10.1016/j.jos.2018.09.002 CR - Gailey R, Allen K, Castles J, Kucharik J, Roeder M. Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use. J Rehabil Res Dev. 2008;45(1):15-29. doi:10.1682/jrrd.2006.11.0147 CR - Kar Z, Kutlu A. Investigation of body ımage and quality of life of patients with lower limb amputation: problems experienced of patients. Niger J Clin Pract. 2023;26(11):1685-1695. doi:10.4103/njcp.njcp_307_23 CR - Heitzmann DWW, Leboucher J, Block J, et al. The influence of hip muscle strength on gait in individuals with a unilateral transfemoral amputation. PLoS One. 2020;15(9):e0238093. doi:10.1371/journal.pone. 0238093 CR - Long IA. Normal shape-normal alignment (NSNA) above-knee prosthesis. Clin Prosthet Orthot. 1985;9(4):9-14. CR - Sabolich J. Contoured Adducted Trochanteric-Controlled Alignment Method (CAT-CAM); introduction and basic princi ples. Clin Prosthet Orthot. 1985;9:15-26. CR - Hachisuka K, Umezu Y, Ogata H, Ohmine S, Shinkoda K, Arizono H. Subjective evaluations and objective measurements of the ischial-ramal containment prosthesis. J UOEH. 1999;21(2):107-118. doi:10.7888/juoeh. 21.107 CR - Gailey RS, Lawrence D, Burditt C, Spyropoulos P, Newell C, Nash MS. The CAT-CAM socket and quadrilateral socket: a comparison of energy cost during ambulation. Prosthet Orthot Int. 1993;17(2):95-100. doi:10. 3109/03093649309164363 CR - Flandry F, Beskin J, Chambers RB, Perry J, Waters RL, Chavez R. The effect of the CAT-CAM above-knee prosthesis on functional rehabilitation. Clin Orthop Relat Res (1976-2007). 1989;239:249-262. CR - Fairley M. MAS Socket: a transfemoral revolution. O&P Edge. 2004. CR - Goujon-Pillet H, Sapin E, Fodé P, Lavaste F. Three-dimensional motions of trunk and pelvis during transfemoral amputee gait. Arch Phys Med Rehabil. 2008;89(1):87-94. doi:10.1016/j.apmr.2007.08.136 CR - Sjödahl C, Jarnlo GB, Söderberg B, Persson BM. Kinematic and kinetic gait analysis in the sagittal plane of trans-femoral amputees before and after special gait re-education. Prosthet Orthot Int. 2002;26(2):101-112. doi:10.1080/03093640208726632 CR - Morino S, Ishihara M, Umezaki F, Hatanaka H, Yamashita M, Aoyama T. Pelvic alignment changes during the perinatal period. PLoS One. 2019; 14(10):e0223776. doi:10.1371/journal.pone.0223776 CR - Azevedo DC, Santos H, Carneiro RL, Andrade GT. Reliability of sagittal pelvic position assessments in standing, sitting and during hip flexion using palpation meter. J Bodyw Mov Ther. 2014;18(2):210-214. doi:10. 1016/j.jbmt.2013.05.017 CR - Gottschalk F. The importance of soft tissue stabilization in trans-femoral amputation : English version. Orthopade. 2016;45(Suppl 1):S1-S4. doi:10.1007/s00132-015-3098-8 CR - Köhler TM, Blumentritt S, Braatz F, Bellmann M. The impact of transfemoral socket adduction on pelvic and trunk stabilization during level walking-a biomechanical study. Gait Posture. 2021;89:169-177. doi: 10.1016/j.gaitpost.2021.06.024 CR - Gaunaurd I, Gailey R, Hafner BJ, Gomez-Marin O, Kirk-Sanchez N. Postural asymmetries in transfemoral amputees. Prosthet Orthot Int. 2011;35(2):171-180. doi:10.1177/0309364611407676 CR - Ezhumalai K, Padhi A, Mohanty RK, Pradhan R, Mohanty P. Influence of femur length on asymmetry of prosthetic gait biomechanics in transfemoral amputation. J Mech Med Biol. 2024;24(05):2350099. doi: 10.1142/S0219519423500999 CR - Michaud SB, Gard SA, Childress DS. A preliminary investigation of pelvic obliquity patterns during gait in persons with transtibial and transfemoral amputation. J Rehabil Res Dev. 2000;37(1):1-10. CR - Karimi MT, Kavyani M, Mehrvar A. Osseointegration: a new approach to improve functional performance of prostheses–a systematic review of the literature. Curr. Orthop. Pract. 2024;35(6):229-236. doi:10.1097/BCO.0000000000001275 CR - Ravari R, Rehani M, Hebert JS. Biomechanical characteristics of transfemoral bone-anchored prostheses during gait: a review of literature. Prosthet Orthot Int. 2024;48(4):412-421. doi:10.1097/PXR. 0000000000000263 UR - https://doi.org/10.32322/jhsm.1607601 L1 - http://dergipark.org.tr/tr/download/article-file/4468343 ER -